How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $7,244.36 | Facility | None | $177.83 | $288.40 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $288.40 | Professional | None | $177.83 | $199.53 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $208.93 Typical High $302.00 | Facility | None | $58.88 | $208.93 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $380.19 | Professional | None | $154.88 | $223.87 | $380.19 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $316.23 | Professional | None | $141.25 | $204.17 | $316.23 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $93.33 Typical High $144.54 | Professional | 52 · Reduced service | $89.13 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $37.15 Typical High $57.54 | Professional | 53 · Discontinued | $35.48 | $37.15 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $141.25 Typical High $218.78 | Professional | 54 · Surgery only | $134.90 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $43.65 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.62 Typical High $28.84 | Professional | 56 · Pre-op care only | $17.78 | $18.62 | $28.84 |
Where Delaware sits
The same service costs 4.0 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Delaware· 49th of 51
$204
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.